A client comes to the clinic complaining of sore throat, fatigue, and headache. The client lives in a dormitory and has been feeling ill for several weeks. Upon assessment of the client the nurse notes the cervical lymph nodes are enlarged. What does the nurse suspect the client has?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Infectious Mononucleosis. The nurse suspects this diagnosis because the client presents with classic symptoms of sore throat, fatigue, headache, and enlarged cervical lymph nodes, which are indicative of infectious mononucleosis, commonly caused by the Epstein-Barr virus. Option A) Lymphomas are a group of blood cancers that can also present with enlarged lymph nodes, but typically do not manifest with the acute symptoms described in the client's presentation. Option B) Lymphedema is swelling due to a blockage in the lymphatic system and is not associated with the acute symptoms mentioned. Option C) Lymphangitis is an infection of the lymphatic channels, which would present with red streaks on the skin and fever, rather than the sore throat and fatigue described in the client. This question is crucial in a Hematology Oncology exam as it tests the student's ability to differentiate between various conditions presenting with similar symptoms, enhancing their clinical reasoning skills in diagnosing hematologic and oncologic disorders based on patient presentations. Understanding the distinguishing features of each condition is vital for accurate diagnosis and appropriate patient management.

Correct Answer: C

Rationale: In this scenario, the most important action before defibrillation in a patient with a temporary pacemaker is to turn the pacemaker off and disconnect both wires. This is crucial to avoid interference between the pacemaker and the defibrillator, which could potentially lead to ineffective defibrillation or harm to the patient. Option A, giving pain medication before defibrillation, is not the priority in this case as the immediate concern is ensuring the safety and effectiveness of the defibrillation process. Option B, defibrillating the patient immediately while the pacemaker is still on, can lead to interference with the pacemaker's function and may not deliver the necessary shock to restore the heart's normal rhythm. Option D, calling the physician before defibrillation, may cause a delay in the life-saving intervention needed in an emergency situation like ventricular fibrillation. Immediate action to turn off the pacemaker and disconnect its wires is crucial to ensure successful defibrillation. Educationally, this question highlights the importance of understanding the potential interactions between medical devices in emergency situations. It emphasizes the need for healthcare providers to have the knowledge and skills to prioritize actions to maximize patient safety and outcomes during critical events.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) 50 gtt./min. To understand why this is the correct flow rate, we need to consider the components of the question. Mr. Kirby is receiving 250 ml of D5W with 1 mg of isoproterenol every 5 hours. The administration set delivers 60 gtt./ml. To calculate the flow rate in drops per minute, we need to consider the total volume to be infused over 5 hours and the drip factor of the administration set. First, we need to calculate the total volume to be infused in 5 hours: 250 ml every 5 hours = 50 ml/hour Next, we convert ml/hour to drops per minute using the drip factor: 1 ml = 60 gtt. 50 ml = 50 * 60 gtt. = 3000 gtt. Since the total volume is to be infused over 5 hours, and we need to find the flow rate in drops per minute: 3000 gtt. / 300 minutes = 10 gtt./min Therefore, the correct flow rate is 50 gtt./min, as option C states. Option A) 5 gtt./min, Option B) 10 gtt./min, and Option D) 1 gtt./min are incorrect because they do not accurately calculate the flow rate based on the information provided in the question. In an educational context, understanding how to calculate intravenous flow rates is crucial for nurses and healthcare professionals to ensure accurate medication administration and patient safety. This question challenges learners to apply their knowledge of drip factors, volume calculations, and time conversions to determine the appropriate flow rate for intravenous therapy. Mastering these calculations is essential in providing quality patient care and preventing medication errors.

Correct Answer: B

Rationale: In early pregnancy, simple anemia can develop due to increased blood volume and demands for iron by the growing fetus. The correct advice for the nurse to give the woman in this scenario is to increase dietary protein, iron, and vitamins (Option B). This recommendation is crucial as it helps to address the underlying cause of anemia and supports the woman and her developing baby's nutritional needs. Option A, checking the pulse three times a day, is incorrect as it does not directly address the nutritional deficiency that is causing the anemia. Monitoring the pulse may be important in certain situations but is not the priority in this case. Option C, restricting rest, is also incorrect. Rest is important during pregnancy, especially when anemia is present, but it is not the primary intervention needed to address the nutritional deficiencies causing the anemia. Option D, avoiding overeating, is not the correct advice either. While maintaining a healthy diet is important, simply avoiding overeating does not specifically address the need for increased intake of essential nutrients like iron, protein, and vitamins that are necessary to combat anemia. Educationally, this question highlights the importance of understanding the nutritional needs of pregnant women, especially when complications like anemia arise. It reinforces the significance of providing appropriate dietary advice to support both the mother and the developing fetus during pregnancy. By choosing the correct answer, nurses can help prevent and manage anemia effectively, promoting better maternal and fetal outcomes.

Correct Answer: B

Rationale: In the acute phase of pernicious anemia, nursing care should focus on addressing the symptoms and complications of the condition. Bed rest with range-of-motion exercises is the correct option because it helps prevent complications like deep vein thrombosis and promotes circulation without exerting excessive energy that the patient may lack due to anemia. Option A is incorrect as placing limits on food, fluids, and activity can worsen the patient's condition by restricting essential nutrients and preventing necessary movement. Option C, preparation for blood transfusion, is incorrect because pernicious anemia is primarily due to vitamin B12 deficiency, not necessarily a lack of blood that would require a transfusion. Option D, providing a heating pad, is incorrect as warmth does not address the underlying cause or symptoms of pernicious anemia. Educationally, understanding the rationale behind the correct answer emphasizes the importance of tailored nursing care for patients with pernicious anemia. It highlights the need for interventions that address the specific needs and symptoms of the condition to promote optimal patient outcomes. This question also reinforces the significance of knowledge in providing evidence-based care to individuals with hematologic disorders.